Economic burden of growth hormone deficiency among adults who are at risk for and who have confirmed growth hormone deficiency using US real-world data.

BACKGROUND

Underdiagnosis and the absence of a condition-specific diagnostic code have made the economic burden of adult growth hormone deficiency (AGHD) difficult to capture. This study measured all-cause and disease-specific healthcare utilization and costs of AGHD among individuals stratified by diagnosis status and receipt of growth hormone (GH) treatment.

METHODS

Adults meeting ≥1 of the following criteria (1/1/2017-12/31/2021): diagnosis of hypopituitarism or related condition, ≥3 pituitary hormone deficiencies, ≥3 pituitary hormone treatments, or ≥1 GH prescription were identified in the Veradigm Network EHR linked to claims. Individuals were stratified by GH level on or before the earliest qualifying event: confirmed (GH < 3 ng/mL), at-risk (no test result), ruled-out (GH ≥ 3 ng/mL). Confirmed and at-risk individuals were segmented by GH treatment. An age and gender-matched control cohort without AGHD was identified. Healthcare utilization and costs were measured in the 12-month post-index period. Multivariable modeling compared all-cause and AGHD-related healthcare costs, excluding cost of GH, among diagnosis- or treatment status-stratified cohorts while adjusting for baseline characteristics.

RESULTS

Among 54,310 individuals at risk for AGHD and 268 with confirmed AGHD, 3.1% and 9.7% received GH treatment, respectively. Study subjects were, on average, 50 years old and majority female. Adjusted all-cause healthcare costs were higher among at-risk individuals (cost ratio [95% confidence interval]: 2.37 [2.26-2.49]) and among confirmed individuals (2.11 [1.52-3.43]) compared to controls. Adjusted annual AGHD-related costs were lower among confirmed individuals compared to at-risk individuals (0.62 [0.52-0.76]) and among treated individuals compared to untreated individuals (0.55 [0.47-0.64]) for those initiating GH therapy.

CONCLUSIONS

All-cause healthcare costs were higher among individuals with confirmed AGHD or at risk for AGHD than among adults without GHD. After excluding the cost of GH therapy, lower adjusted AGHD-related costs were associated with both a confirmed AGHD diagnosis and receipt of GH treatment.